Individual provider Active NPI

Jaclyn Patterson

  • Critical Care Medicine Nurse Practitioner
  • Marlton, NJ
National Provider Identifier
1609697994
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
26NR15677000 Issued in NJ
Practice address
141 Route 70 E Ste B
Renaissance Square
Marlton, NJ 08053-1855
Phone
(856) 596-9057
Fax
(856) 596-0837
NPI assigned
Oct 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LC0200X 26NR15677000 NJ Primary

Addresses

Primary practice location

141 Route 70 E Ste B
Renaissance Square
Marlton, NJ 08053-1855

Mailing address

301 Lippincott Dr Ste 410
Marlton, NJ 08053-4197
Phone (856) 596-9057

Other practice location 1

100 Harvard Ave
Collingswood, NJ 08108-1406
Phone (856) 816-1946

Other practice location 2

1600 Haddon Ave
Camden, NJ 08103-3101
Phone (856) 757-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205003856 NJ Practitioner - Nurse Practitioner 4880124882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

141 Route 70 E
Suite E
Marlton, NJ 08053-1855
Phone (856) 985-7373

Hospital & facility affiliations

  • Virtua Mount Holly Hospital Hospital, Mount Holly, NJ, CCN 310057
  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022
  • Virtua Willingboro Hospital Hospital, Willingboro, NJ, CCN 310061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NR15677000NJMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Multi-Specialty CurrentSince Feb 2, 2025 Accepting new patients
Virtua Medical Group, PA CurrentSince Feb 2, 2025 Accepting new patients
Virtua Medical Group, PA Multi-Specialty Current Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1600 Haddon Ave
Camden, NJ 08103
Phone (609) 757-3500

141 Route 70 E
Frnt
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Ste 200
Marlton, NJ 08053
Phone (856) 355-0335

141 Route 70 E
Ste B
Marlton, NJ 08053
Phone (856) 596-9057

301 Lippincott Dr
Ste 410
Marlton, NJ 08053

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1609697994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 LIPPINCOTT DR STE 410",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534197",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 ROUTE 70 E STE B",
            "address_2": "RENAISSANCE SQUARE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531855",
            "telephone_number": "856-596-9057",
            "fax_number": "856-596-0837"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Harvard Ave",
            "address_purpose": "LOCATION",
            "city": "Collingswood",
            "state": "NJ",
            "postal_code": "081081406",
            "country_code": "US",
            "telephone_number": "856-816-1946",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Haddon Ave",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "856-757-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JACLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "NJ",
            "license": "26NR15677000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.